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. 2022 Dec 31:2022:6926510.
doi: 10.1155/2022/6926510. eCollection 2022.

Biomarkers for Predicting the Occurrence and Progression of Atrial Fibrillation: Soluble Suppression of Tumorigenicity 2 Protein and Tissue Inhibitor of Matrix Metalloproteinase-1

Wei-Ping Sun  1 , Xiao Du  1 , Jun-Jun Chen  1
Affiliations

Biomarkers for Predicting the Occurrence and Progression of Atrial Fibrillation: Soluble Suppression of Tumorigenicity 2 Protein and Tissue Inhibitor of Matrix Metalloproteinase-1

Wei-Ping Sun et al. Int J Clin Pract. .

Abstract

Background: Soluble suppression of tumorigenicity 2 protein (sST2) and tissue inhibitor of matrix metalloproteinase (TIMP)-1 are involved in multiple pathogenic pathways, including cardiac remodeling, which is the main pathology of atrial fibrillation (AF). This study aims to investigate the previously unexplored relationship between the serum levels of sST2, TIMP-1, and AF.

Methods: This was a prospective cross-sectional study conducted at the Capital Medical University Affiliated Beijing Anzhen Hospital between June 2019 and July 2020, with a total of 359 participants. The clinical characteristics and laboratory results of the patients were compared, and multivariable ordinal logistic regression was used to evaluate the relationship between serum sST2, TIMP-1, and AF.

Results: The participants included 110 patients with sinus rhythm (SR), 113 with paroxysmal AF (the paroxysmal AF group), and 136 with persistent AF (the persistent AF group). It was found that the sST2 levels gradually increased in these three groups, from 9.1 (6.7-12.4 pg/ml) in the SR group to 14.0 (10.4-20.8 pg/ml) in the paroxysmal AF group and to 19.0 (13.1-27.8) pg/ml) in the persistent AF group (p < 0.001). The multivariable ordinal logistic regression model for sST2 and TIMP-1 demonstrated that sST2 had an area under the receiver operating characteristic (ROC) curve (AUC) of 0.797 (95% confidence interval (CI) 0.749-0.846, p < 0.001) and TIMP-1 had an AUC of 0.795 (95% CI 0.750-0.841, p=0.000). The multivariable ordinal logistic regression model for sST2 and TIMP-1 showed good discrimination between SR and AF, with an AUC of 0.846, and the addition of clinical factors, such as brain natriuretic peptide (BNP), left atrial diameter, age, and gender, to the biomarker model improved the detection of SR and AF (AUC 0.901).

Conclusions: In this cohort study, sST2 and TIMP-1 were associated with AF progression, independent of clinical characteristics and biomarkers. Soluble ST2 and TIMP-1 combined with age, elevated N-terminal-pro hormone BNP(NT-BNP), and an enlarged left atrium were able to demonstrate the progression of AF reliably.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Patient selection flowchart.
Figure 2
Figure 2
Soluble suppression of tumorigenicity 2 protein, tissue inhibitor of matrix metalloproteinase, and brain natriuretic peptide levels and the left atrial diameter.
Figure 3
Figure 3
A receiver operator characteristic curve analysis for the progression of atrial fibrillation. (a) Sinus rhythm and atrial fibrillation. (b) Sinus rhythm and paroxysmal atrial fibrillation. (c) Sinus rhythm and persistent atrial fibrillation.
Figure 4
Figure 4
A receiver operator characteristics curve analysis with different factors for assessing the progression of atrial fibrillation. (a) Tissue inhibitor of matrix metalloproteinase (TIMP-1) and soluble suppression of tumorigenicity 2 protein (sST2) individually. (b) TIMP-1 and sST2 combined. (c) TIMP-1, sST2, brain natriuretic peptide (BNP), and left atrial diameter (LAD) combined. (d) TIMP-1, sST2, BNP, LAD, age, and gender combined.
See this image and copyright information in PMC

References

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